More Research on Child Maltreatment Urgently Needed, AHRQ Report Says
April 22, 2013
Fifteen percent of Hispanics received medical care for high blood pressure in 2010, compared with 30 percent of blacks and 27 percent of whites. Spending averaged $981 for every Hispanic patient treated for blood pressure, compared with $679 for white non-Hispanic patients. (Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #404, Expenditures for Hypertension among Adults Age 18 and Older, 2010 Estimates for the U.S. Civilian Noninstitutionalized Population.)
- More Research on Child Maltreatment Urgently Needed, AHRQ Report Says.
- CMS Memo Encourages Wider Use of AHRQ’s Common Formats.
- Spots Still Available for April 25 Webinar on the National Quality Strategy.
- Patient-Centered Medical Home Research Methods Series Now Available.
- Report Says Effectiveness Studies of Hospital Fall Prevention Methods Need Improvement.
- Research Review Finds Migraine Drugs are Generally Effective but Carry Side Effects.
- Register Now for April 25 Web Event Series on Accountable Care Organizations and Patient-Centered Medical Homes.
- AHRQ in the professional literature.
An urgent need exists to build and improve upon the evidence base for interventions promoting the well-being of maltreated children, according to a new research review from AHRQ’s Effective Health Care Program. While treatment recommendations are still preliminary, a number of interventions show promising comparative benefit for improving child well-being outcomes. The two approaches that have emerged with relatively strong evidence are: SafeCare, a home-visiting approach involving maltreating parents; and Keeping Foster Parents Trained and Supported (KEEP), a foster parent training program. However, more methodologically rigorous research is needed to evaluate these and other interventions due to limited evidence. Select to access the full review, titled Child Exposure to Trauma: Comparative Effectiveness of Interventions Addressing Maltreatment.
A recent memo from CMS describes how the use of AHRQ’s Common Formats may help hospitals meet CMS’ Quality Assessment and Performance Improvement (QAPI) requirements. Hospitals are required to track adverse patient events as a Condition of Participation for QAPI requirements. Although the use of Common Formats is voluntary, CMS encouraged surveyors in the March 15 memo to become familiar with them. A hospital using Common Formats and is adept at the analysis that this structured system permits will be in a better position to meet the CMS QAPI requirements, according to the memo. Select to access the memo on the CMS Web site. Select to access more information about Common Formats or send an email to AHRQ’s Patient Safety Organization Office at: PSO@ahrq.hhs.gov.
AHRQ is sponsoring a webinar on April 25 from 2:00 to 3:00 p.m. EDT to provide an update on the National Quality Strategy (NQS), a national effort to align public- and private-sector stakeholders to achieve better health and health care for all Americans. Nancy Wilson, M.D., of AHRQ, will discuss ongoing implementation of NQS, which was created as part of the Affordable Care Act and is led by HHS. Also featured will be tools and resources that can help organizations promote NQS’ aims and priorities. Select to register for the webinar. Select to access more information about NQS.
The Patient Centered Medical Home (PCMH) Research Methods Series, funded by AHRQ, is designed to expand awareness of methods to evaluate and refine PCMH models and other health care interventions. These novel and underused methods can be used by evaluators and implementers to better assess and refine PCMH models and to meet the evidence needs of PCMH stakeholders more effectively. Each of the briefs describes a PCMH method, outlines its advantages and limitations, and provides resources for researchers to learn more about the method. This series was developed with input from nationally recognized leaders in research methods and PCMH models. Select to access the PCMH Research Methods Series.
Promising interventions exist for preventing hospital patients from falling, but the authors of a new AHRQ-funded literature review found that only a small proportion reported sufficient data to evaluate their effectiveness. To better determine effectiveness, a new report from AHRQ’s Southern California Evidence-based Practice Center says that interventions should include better outcomes documentation, more information about comparison groups, and details about the components, implementation, and adherence. The report authors analyzed 59 studies published over 28 years that met their inclusion criteria. "Hospital Fall Prevention: A Systematic Review of Implementation, Components, Adherence, and Effectiveness," was published online on March 25 in the Journal of the American Geriatrics Society. Select to access the abstract on PubMed®.
Approved drug treatments for chronic and episodic migraine are mostly effective; however, their usage increases the risk of negative effects, causing patients to stop taking them, according to a new research review from AHRQ’s Effective Health Care Program. For chronic migraine, the medicine onabotulinumtoxin A reduces migraine attacks by more than 50 percent, but carries the risk of adverse effects and treatment discontinuation. For episodic migraine, all approved drugs—such as topiramate, opiramate, divalproex, timolol, and propranolol—are effective in reducing monthly migraine frequency but similarly increase both the risk of adverse effects and treatment discontinuation. Between 17 percent and 29 percent of patients discontinue preventive migraine medication because of adverse effects such as anxiety, nausea, vomiting, sleep time reduction, drowsiness, or weakness. Compared with approved migraine drugs, some off-label beta blockers and angiotensin-inhibiting drugs are more effective and safer for preventing adult migraine, according to the findings. Future research is needed on the comparative effectiveness of approved migraine drugs and the most effective off-label ACE inhibitors, angiotensin II blockers, and off-label beta blockers. Select to access the full review, titled Migraine in Adults: Preventive Pharmacologic Treatments.
Join the AHRQ Health Care Innovations Exchange for the first in a series of Web events designed to share experiences and lessons learned in putting accountable care organization (ACOs) and patient-centered medical home principles into practice. The series begins on April 25, from 1:00 to 2:00 p.m. EDT, with Payment Models That Support Medical Home and Accountable Care Organization Principles: Maryland’s Experience. Learn about Maryland’s Multi-Payer Program, a statewide initiative that supports the development of patient-centered medical homes with novel financial incentive structures designed to promote provider participation. You’ll also learn about innovative payment models aimed to support medical homes and the principles underlying ACOs with an interactive discussion on key issues. Select to register for this event and read about the featured innovation profile. Select to access additional information about the participants.
Blackstock OJ, Beach MC, Korthuis T, et al. HIV providers' perceptions of and attitudes toward female versus male patients. AIDS Patient Care STDS 2012 Oct; 26(10):582-8. Select to access the abstract on PubMed®.
Kastenberg ZJ, Rhoads KF, Melcher ML, et al. The influence of intern home call on objectively measured Perioperative outcomes. Arch Surg 2012 Dec 17. Select to access the abstract on PubMed®.
Zhu VJ, Grannis SJ, Tu W, et al. Evaluation of a clinical decision support algorithm for patient-specific childhood immunization. Artif Intell Med 2012 Sep; 56(1):51-7. Select to access the abstract on PubMed®.
Selby JV, Schmittdiel JA, Fireman B, et al. Improving treatment intensification to reduce cardiovascular disease risk: a cluster randomized trial. BMC Health Serv Res 2012 Jul 2; 12:183. Select to access the abstract on PubMed®.
Ratanawongsa N, Korthuis PT, Saha S, Roter D, Moore RD, Sharp VL, Beach MC. Clinician stress and patient-clinician communication in HIV care. J Gen Intern Med 2012 Dec; 27(12):1635-42. Select to access the abstract on PubMed®.
Koplan KE, Brush AD, Packer MS, Zhang F, Senese MD, Simon SR. "Stealth" alerts to improve warfarin monitoring when initiating interacting medications. J Gen Intern Med 2012 Dec; 27(12):1666-73. Select to access the abstract on PubMed®.
Biggins SW, Bambha KM, Terrault NA, et al. Projected future increase in aging hepatitis C virus-infected liver transplant candidates: a potential effect of hepatocellular carcinoma. Liver Transpl 2012 Dec; 18(12):1471-8. Select to access the abstract on PubMed®.
Norton BL, Park L, McGrath LJ, et al. Health care utilization in HIV-infected patients: assessing the burden of hepatitis C virus coinfection. AIDS Patient Care STDS 2012 Sep; 26(9):541-5. Select to access the abstract on PubMed®.
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